Article Text

Download PDFPDF

165 Frail older patients have a greater improvement in physical quality of life following invasive management for non-ST elevation acute coronary syndrome
  1. Zhaotao Sophie Gu1,
  2. Danny Chan2,
  3. Ben Beska3,
  4. Hannah Sinclair4,
  5. Weiliang Qiu5,
  6. Vijay Kunadian6
  1. 1Newcastle University
  2. 2Freeman Hospital
  3. 3Harvard University

Abstract

Introduction Frailty, defined as a vulnerability to physiological stressors due to a decline in reserve with age, is common in older patients with non-ST elevation acute coronary syndrome (NSTEACS) and is associated with a disproportionately high morbidity and mortality. We aimed to determine how frailty influences physical quality of life (QoL) outcomes after invasive treatment for NSTEACS.

Methods 298 patients aged ≥75 years with NSTEACS were enrolled into a multicentre prospective observational study, 297 (99.7%) completed QoL questionnaires at baseline. Frailty was assessed using the Fried criteria, where a score of 0 is robust, 1 or 2 is pre-frail and ≥3 is frail. QoL was assessed by Short Form-36 (SF-36) questionnaire (license number QM033917) at baseline and 1 year follow-up. The norm-based physical component score (PCS), an aggregated summary score of the 8 SF-36 subscales, is reported.

Results Mean age was 80.4±4.8 years, 61.7% male, 86.6% received invasive treatment (percutaneous coronary intervention or coronary artery bypass grafting), and 234 (78.8%) patients completed 1-year follow-up QoL assessment. At presentation, 56 (18.9%) patients were robust, 160 (53.9%) were pre-frail and 81 (27.3%) were frail. There was no difference in proportional of patients received invasive management among frailty groups (89.3% of robust, 83.8% of pre-frail and 90.1% frail patients were treated invasively, p=0.30). Increasing frailty was associated with decreased physical QoL at both baseline and 1 year (p<0.001 for both time points). Although all frailty groups saw an increase in mean PCS, this difference was only statistically significant in pre-frail and frail patients (robust: 42.7±10.7 to 44.2±11.8, p=0.409; pre-frail: 37.7±11.1 to 41.3±11.4, p=0.001; frail: 27.9±8.5 to 32.5±12.6, p=0.04). In addition, only pre-frail and frail patients who received invasive treatment saw this significant improvement in PCS between baseline and 1 year, although numbers receiving medical therapy only was low (figure 1).

Abstract 165 Figure 1

Change in PCS by frailty and treatment

Conclusion Although frail older patients with NSTEACS have a poorer physical QoL overall, our data suggest frailty is associated with a greater improvement from baseline QoL in those who receive invasive treatment.

Conflict of Interest None

  • quality of life
  • NSTEACS
  • frailty

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.